Effects of prepregnancy weight, gestational weight gain and other related factors on antepartum depression

Objective To explore the effects of pre-pregnancy weight, gestational weight gain(GWG) and other relevant factors on antepartum depression.

Methods A total of 559 singleton pregnant women were selected as research objects. According to the pre-pregnancy body mass index (BMI), the pre-pregnancy body mass was divided into pre-pregnancy underweight (BMI < 18.5 kg/m²), normal body weight (BMI 18.5 to 25 kg/m²) and overweight/obese (BMI≥25.0 kg/m²). Further according to the GWG recommended value by the Institute of Medicine (IOM), GWG were divided into insufficient GWG, appropriate GWG and excessive GWG. The correlations of pre-pregnancy weight, GWG and other related factors with pre-pregnancy score of Edinburgh Postnatal Depression Scale (EPDS) were analyzed.

Results Among 559 pregnant women, there were 54 cases (9.7%) of low body weight before pregnancy, 427 cases (76.4%) of normal body weight, 78 cases (13.9%) of overweight/obese, 96 cases (17.2%) of insufficient GWG, 191 cases (34.2%) of appropriate GWG, 272 cases (48.7%) of excessive GWG. 65.4% (51/78) of overweight/obese pregnant women had excessive GWG before pregnancy. Single factor analysis results showed that there were significant differences in pre-pregnancy EPDS score among underweight, normal weight and overweight/obese pregnant women (P=0.035). There was no significant difference in pre-pregnancy EPDS among pregnant women with insufficient GWG, appropriate GWG and excessive GWG (P=0.388). There were significant differences in pre-pregnancy EPDS scores among pregnant women with different quality of life satisfaction and different pregnancy intention(P=0.002, P=0.005). Multiple linear regression analysis results showed that pregnancy intention, quality of life satisfaction, parity, overweight/obesity were influencing factors of pre-pregnancy EPDS score(P < 0.05). Pre-pregnancy EPDS score was negatively correlated with pregnancy intention, quality of life satisfaction and parity, and was positively correlated with overweight/obesity before pregnancy.

Conclusion Pre-pregnancy body mass, pregnancy intention, satisfaction of quality of life, and delivery time are the influencing factors of pre-pregnancy depression, while GWG has no correlation with pre-pregnancy depression. Prevention of depression during pregnancy in overweight/obese women should focus on intervention of overweight/obesity before pregnancy. In the perinatal health care work, medical staff should pay attention to the psychological state of pregnant women with unwanted pregnancy and low satisfaction of life quality, thereby improving their pregnancy outcome.